Economic pressures have strongly influenced the development of reconstructive surgery,
with a long trend of decreasing numbers of reconstructive surgery practices and procedures
associated with decreasing reimbursements. Previously, these authors have reported
an analysis model to evaluate the financial impact of reconstructive cases on hospital
revenues, with the added premise, that if profits existed, they could be partially
used to support and further develop reconstructive practice. They have applied this
model to assess the performance of an operational reconstructive surgery center.
In April 2001, the University of Mississippi established the Center for Microsurgery
and Complex Reconstruction. The authors have analyzed the cases managed in the Center,
including microsurgical flaps, replants, nerve reconstruction, secondary and associated
cases. During the same time period, financial data were also analyzed for non-Center
plastic surgery cases (cosmetic, breast reduction, etc.) and inpatient consults. Data
consisted of actual hospital income, direct costs, indirect costs, and calculated
profit (or loss).
Center cases showed a sustained hospital profit of greater than 20% of gross revenue
over a 2-year period. Routine cases were unprofitable, while losses associated with
inpatient consults decreased over the same period. The decreased losses with consults
may be related to a very visible and active reconstructive surgery consult service.
This analysis was able to specify the impact of specialty cases on hospital revenue.
In this study, specialty reconstructive cases were shown to be profitable. This kind
of analysis can be used to identify hospital revenues related to specific patient
groups and make cases for practice development support.
